Young people do not associate e-cigarettes with increased likelihood of smoking

New research suggests availability of e-cigarettes makes smoking appear less attractive to young people, discourages tobacco uptake

Centre for Substance Use and Research, Glasgow, 8 March 2017 – New peer-reviewed research published today in Drugs Education Prevention and Policy shows that e-cigarettes are not increasing the likelihood of tobacco consumption and may in fact be contributing to negative perceptions about smoking among young people.

The study, based on semi-structured interviews with 50 vapers between the ages of 16 and 26 – including 28 current smokers, 19 former smokers and 3 never smokers — found the majority of young people think e-cigarettes are a substantially less harmful alternative to combustible tobacco and don't believe that vaping is increasing their likelihood of smoking.

"What is interesting about our research is that the availability of vaping products might be contributing to even worse perceptions of tobacco in this age group," said Dr. Neil McKeganey, Director of the Centre for Substance Use Research (CSUR) and lead author of the study. "Young people are rationalizing that, because a much less harmful alternative exists, then logically it makes even less sense to consume tobacco."

While the visual similarity between tobacco cigarettes and vaping products has given rise to concerns that e-cigarettes may "renormalise" smoking, it remains unclear exactly what is meant by a process of "smoking renormalisation" or indeed how the use of e-cigarettes can be specifically attributed to it.

"What we know is that all vapers are overwhelmingly current and former smokers," said McKeganey. "We also know that as e-cigarette devices have evolved, vaping and smoking have become visually quite distinctive from one another. While some young people we interviewed drew obvious comparisons between the two — namely, inhalation and nicotine consumption — it is clear that, for the most part, they perceive e-cigarettes as vastly different from smoking. More importantly, there was overwhelming consensus amongst our participants that vaping is not making smoking more socially acceptable and that, if anything, it is making cigarettes seem even less acceptable."

This research supports the conclusions of other studies that have failed to find any demonstrable link between e-cigarette use and increased likelihood of tobacco consumption. In the UK, where nearly 3 million people are currently vaping, smoking rates continue to fall and according to Action on Smoking and Health only 2 percent of vapers are never-smokers.

"What our research shows is that young people clearly perceive e-cigarettes for what they are – a less harmful alternative to tobacco. Equally, though, this view does not, as one might assume, directly translate into 'risk-free' in their minds. To the contrary, some interviewees said they were concerned that e-cigarettes might be associated with unknown risks over the longer term, which also tells us that young people are experimenting with a certain degree of caution."

"Regulators need to fully recognise the context in which young people are trying and using e-cigarettes and our research does not support alarmist views that vaping will suddenly undo or reverse decades of successful tobacco control. With this in mind, any concerns about youth experimentation must be balanced against the growing body of evidence that demonstrates the increasingly obvious link between e-cigarettes and smoking cessation across the population as a whole."

"I think smoking is less acceptable if anything because there's an alternative now to smoking cigarettes so in that way I think its maybe the opposite of having made smoking more acceptable." — 26-year-old female occasional vaper

"Because smoking is less healthier so vaping becomes more common if anything. I think smoking would be less accepted because it would be like well there's an alternative that's better for you, it's less offensive to people around you so why are you smoking when you could be vaping. I think it would make smoking less accepted if vaping got more popular." — 22-year-old male ex-smoker occasional vaper

"They're clearly different to me. The smoke that comes off vape is big plumes that last a lot longer than cigarette smoke and also you can smell them a lot of the time before you see them with all the different flavours they have." — 22-year-old male occasional vaper

"Well obviously people know the damage that can be done by smoking tobacco and I think smoking tobacco is a lot worse to the user themselves and everyone around them because second hand smoke obviously can affect anyone. I'm not sure about the second hand smoke with vaping bit I'm guessing that it's really negligible the damage that can be done so I think definitely cigarettes and tobacco are still quite a bit worse than vape."22-year-old male occasional vaper.

"I think vaping is having an effect on smoking cigarettes in that it's taking it away from it. People are moving off the cigarettes and moving on to vaping because it's the next, as I said, cool thing. I don't think it's having an effect of making people smoke because they're vaping, I think it's taking away from smoking cigarettes" – 22-year-old female occasional vaper